Abstract
The aim of this study is to examine the relationship of caste and class with perceived discrimination among pregnant women from rural western India. A cross-sectional survey was administered to 170 pregnant women in rural Gujarat, India, who were enrolled in a longitudinal cohort study. The Everyday Discrimination Scale and the Experiences of Discrimination questionnaires were used to assess perceived discrimination and response to discrimination. Based on self-report caste, women were classified into three categories with increasing historical disadvantage: General, Other Backward Castes (OBC), and Scheduled Caste or Tribes (SC/ST). Socioeconomic class was determined using the standardized Kuppuswamy scale. Regression models for count and binomial data were used to examine association of caste and class with experience of discrimination and response to discrimination. Sixty-eight percent of women experienced discrimination. After adjusting for confounders, there was a consistent trend and association of discrimination with caste but not class. In comparison to General Caste, lower caste (OBC, SC/ST) women were more likely to (1) experience discrimination (OBC OR: 2.2, SC/ST: 4.1; p trend: 0.01); (2) have a greater perceived discrimination score (OBC IRR: 1.3, SC/ST: 1.5; p trend: 0.07); (3) accept discrimination (OBC OR: 6.4, SC/ST: 7.6; p trend: < 0.01); and (4) keep to herself about discrimination (OBC OR: 2.7, SC/ST: 3.6; p trend: 0.04). The differential experience of discrimination by lower caste pregnant women in comparison to upper caste pregnant women and their response to such experiences highlight the importance of studying discrimination to understand the root causes of existing caste-based disparities.
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Acknowledgements
We are thankful to Dr. Deborah Plummer for her thoughtful comments on understanding discrimination within the context of historically disenfranchised populations.
Funding
This study was supported by 2013 University of Massachusetts Medical School Office of Global Health Pilot Project Grant. Contribution by co-authors was partially supported by TL1-TR001454 (to A.S.) and KL2TR000160 (to N.B.) from National Center for Advancing Translational Sciences, P60-MD006912-05 (to J.A.) from National Institute on Minority Health and Disparities, and Joy McCann Endowment (to T.M.S.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health.
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Consent for participation was obtained by trained interviewers prior to enrollment. Interviewers read the consent to participants in Gujarati, shared a single-page fact sheet about the study with them, and answered questions. Willing participants were asked to sign a separate consent form, and a copy of the form was provided to the participants. Human Research Ethics Committee of HM Patel Center for Medical Care and Education at SKH reviewed the study and approved it. University of Massachusetts Medical School (UMMS) Institutional Review Board reviewed the study and exempted it because of the approval by a local ethics committee in India and the absence of interaction of UMMS researchers with study participants or their identified data. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.
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Khubchandani, J., Soni, A., Fahey, N. et al. Caste matters: perceived discrimination among women in rural India. Arch Womens Ment Health 21, 163–170 (2018). https://doi.org/10.1007/s00737-017-0790-1
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DOI: https://doi.org/10.1007/s00737-017-0790-1